A room of errors simulation to improve pharmacy operators’ knowledge of cytotoxic drug production

Author:

Garnier Alexandra12ORCID,Butaye Louise3,Bonnabry Pascal12,Bouchoud Lucie1

Affiliation:

1. Pharmacy Department, Geneva University Hospitals, Geneva, Switzerland

2. Institute of Pharmaceutical Sciences of Western Switzerland, School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland

3. Pharmacy Department, University Clinics of Saint-Luc, Brussels, Belgium

Abstract

Introduction We used an educational healthcare simulation tool called room of errors (ROE) to raise pharmacy operators’ awareness of potential errors in a chemotherapy production process and assessed its impact on their knowledge and satisfaction. Methods Twenty-five errors (compiled from internal procedures, literature and our hospital's reported incidents) were categorised as static ( n = 7, visible by the participant anytime) and dynamic ( n = 18, made by a pseudooperator in front of the participant). Our simulated cytotoxic production unit (CPU) hosted the 1 h-simulation. Two pharmacists (supervisor/pseudo-operator) welcomed the trainee for a 10-min briefing. During the 20-min simulation, participants watched the pseudo-operator's gestures in a simulated chemotherapy production process. Participants called out each error observed (recorded by the supervisor). A 20-min debriefing followed. ROE's impact on knowledge was measured through participants’ answers to a before-and after 18-item questionnaire about CPU's procedures and certainty about answers on a scale (0%–100%). Participants evaluated the training using a satisfaction questionnaire (Likert scale, 1–6). Results The 14 participants detected 70.4% ± 11.4% of errors. Least-detected errors were “using non-disinfected vials” (42.9%) and “touching syringe plunger” (0%). Critical errors (expired leftovers or glucose instead of sodium chloride) were detected at 57.1%. Knowledge improved from 60.3% to 94.1% (p < 0.001) and certainty from 75.3% to 98.8% (p < 0.001). Participants appreciated this non-judgmental, informative, and original training (satisfaction 95.7%). Some pointed out difficulties settling into the game quickly and visualising static and dynamic errors simultaneously. Conclusion This ROE simulation improved operators’ knowledge and certainty. Longer-term testing should be done to measure knowledge retention over time.

Publisher

SAGE Publications

Subject

Pharmacology (medical),Oncology

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